V 47Amniotic membrane transplantation for acute chemical or thermal burns
1,3D. Meller, 1R. T. F. Pires, 2F. Figueiredo,3A. Heiligenhaus, 3K. P. Steuhl, 1S. C. G. Tseng
Purpose: To determine whether preserved human amniotic membrane (AM) can be used to treat ocular burns in the acute stage.
Patients and Methods: Thirteen eyes (10 chemical and 3 thermal), grades II-III (7 eyes) and grade IV (6 eyes), from 11 patients with acute burns received amniotic membrane transplantation (AMT) within 2 weeks after the injury.
Results: For a follow-up of 8.8 months, 11/13 eyes (84.63%) showed epithelialization within 2 to 5 weeks (23.7 ± 9.8 days), and final visual improvement of ³ 6 lines (6 eyes), 4-5 lines (2 eyes), and 1-3 lines (2 eyes). Only one eye developed a symblepharon. Burns of grade II to III showed more visual improvement (7.3 ± 3 lines) than burns of grade IV (2.3 ± 3.0 lines, p<0.05). In the group with grade II or III, none developed limbal stem cell deficiency. All eyes in the group with grade IV developed limbal stem cell deficiency.
Conclusion: In mild to moderate burns, AMT alone rapidly restores both corneal and conjunctival surfaces, but in severe burns, it restores the conjunctival ocular surface without deliberating symblepharon, reduces limbal stromal inflammation, but does not prevent limbal stem cell deficiency, which requires further limbal stem cell transplantation.
1Ocular Surface and Tear Center, Dept. of Ophthalmology, Bascom Palmer Eye Institute, Univ. of Miami, Miami, USA,